Screening for Asymptomatic Coronary Artery Disease in Kidney Transplant Candidates (CARSK)
Actively Recruiting
About This Study
The CARSK trial evaluates whether eliminating routine, non-invasive coronary artery disease (CAD) screening after waitlist activation is non-inferior to standard periodic screening for preventing major adverse cardiac events. The study population consists of asymptomatic kidney transplant candidates with ESRD who have already undergone initial screening for waitlist entry. Participants are randomized to either no further CAD screening until transplantation or regular screening at annual intervals. Secondary outcomes include the rate of transplantation and the relative cost-effectiveness of each strategy. This trial addresses the lack of evidence supporting the current practice of repetitive cardiac testing in patients awaiting renal replacement therapy.
Who Can Participate?
✓ Inclusion Criteria
- •adults aged 18 years of age or older
- •Dialysis-dependent kidney failure and currently being assessed for OR active on the kidney transplant waiting list
- •expected to require further screening for CAD prior to transplantation (by current standard of care);
- •able to give consent;
- •anticipated to undergo transplantation more than 12 months from date of enrolment
✗ Exclusion Criteria
- •patients with signs or symptoms suggestive of uncontrolled cardiac disease such as unstable coronary syndromes, decompensated heart failure, uncontrolled arrhythmia, and severe valvular heart disease;
- •patients who "on-hold" for transplantation due to a medical problem;
- •patients with other solid organ transplants;
- •multi-organ transplant candidates (e.g. kidney-pancreas transplant candidates);
- •patients with planned living donor transplant;
- •patients unable to give consent.